Devices and methods for anterior arytenoid adduction

Abstract

Provided herein are devices and methods for anterior arytenoid adduction. The device may comprise a wire having a first end and a second end at opposite ends of a longitudinal axis, the wire forming a spiral along the longitudinal axis and having a double hook at the first end, a suture threaded through the spiral of the wire from the second end to the first end, the suture forming a turn at the first end and passing exterior to the spiral to the second end. The method may comprise advancing a suture and hook from the subject's anterior thyroid cartilage or cricothyroid membrane to the muscular process of the subject's arytenoid, attaching the hook to the muscular process, and applying tension to the suture to rotate the muscular process and adduct the arytenoid.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS[0001]This application claims priority to U.S. Provisional Patent Application No. 61 / 625,860, filed Apr. 18, 2012, which is incorporated herein by reference in its entirety.INTRODUCTION[0002]The vocal folds, also known commonly as vocal cords, are two elastic bands of muscle tissue located in the larynx directly above the trachea. When you breathe, your vocal folds remain apart and when you swallow, they are tightly closed. When you use your voice, however, air from the lungs causes your vocal folds to vibrate between open and closed positions. Vocal fold paralysis (“VFP”, also known as vocal cord paralysis) is a voice disorder that occurs when one or both of the vocal folds don't open or close properly. If you have vocal fold paralysis, the paralyzed fold or folds may remain open, leaving the air passages and lungs unprotected. You could have difficulty swallowing, and food or liquids could accidentally enter the trachea and lungs, causing ser...

AI Technical Summary

Benefits of technology

[0009]In another aspect of the present invention, a method of adducting an arytenoid and providing a thyroplasty implant is provided to a subject in need thereof. The method comprises providing a device comprising a first needle enclosing a suture wire complex. The device further comprises a thyroplasty implant having a body with a central aperture, in which the suture is passed through the aperture of the implant. A localizing trocar and first needle (or guide needle enclosing the first needle if used) are passed through the trocar. A second needle can be used and passed through the first needle, the second guide needle at least partially enclosing the suture wire complex. The first needle (or guide needle if used) is passed through an incision in the subject's anterior thyroid cartilage or cricothyroid membrane to the muscular process of the subject's arytenoid. The first needle containing the suture wire complex is then passed over the guide needle, if a guide needle is used. When the first needle reaches the muscular process, the suture wire complex is pushed outside the first needle and the suture wire complex is deployed and attached by the hook to the muscular process, and tension is applied to the suture to rotate the muscular process and adduct the arytenoid and medialize the vocal fold. The implant is then advanced along the suture and placed adjacent to the muscular process to aid in providing bulk to the vocal fold and closing the glottal gap.

Problems solved by technology

When you use your voice, however, air from the lungs causes your vocal folds to vibrate between open and closed positions.

You could have difficulty swallowing, and food or liquids could accidentally enter the trachea and lungs, causing serious health problems.

Furthermore, VFP provides a voice that is weak and breathy and coughing and pulmonary function is impaired.

While injection laryngoplasty is a simple procedure which can be performed within the office, it cannot correct severe atrophy and lateralization caused by paralysis, cannot be reversed, and has an effect which wanes over time.

While arytenoid adduction is a powerful procedure which can dramatically improve voice quality, it is technically challenging to perform.

It is difficult to access the posterior larynx.

Doing so requires a highly invasive procedure; difficulty accessing the posterior larynx can also increase patient morbidity, particularly when done by surgeons inexperienced with the procedure.

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